| Accelerated Benefit Claim
|
Complete to file an accelerated benefit claim.
|
Claims
|
Z1361 04/15
| AK, AL, AR, AZ, CA…
AK,
AL,
AR,
AZ,
CA,
CO,
CT,
DC,
DE,
FL,
GA,
HI,
IA,
ID,
IL,
IN,
KS,
KY,
LA,
MA,
MD,
ME,
MI,
MN,
MO,
MS,
MT,
NC,
ND,
NE,
NH,
NJ,
NM,
NV,
OH,
OK,
OR,
PA,
RI,
SC,
SD,
TN,
TX,
UT,
VA,
VT,
WA,
WI,
WV,
WY
|
|
| Accelerated Benefit Claim
|
Complete to file an accelerated benefit claim.
|
Claims
|
NZ1361 12/18
| NY |
|
| Activation of Lifetime Income Benefit Request
|
Use this form to activate a Lifetime Income Benefit.
|
Other Transactions
|
X4391 06/20
| AK, AL, AR, AZ, CA…
AK,
AL,
AR,
AZ,
CA,
CO,
CT,
DC,
DE,
FL,
GA,
HI,
IA,
ID,
IL,
IN,
KS,
KY,
LA,
MA,
MD,
ME,
MI,
MN,
MO,
MS,
MT,
NC,
ND,
NE,
NH,
NJ,
NM,
NV,
OH,
OK,
OR,
PA,
RI,
SC,
SD,
TN,
TX,
UT,
VA,
VT,
WA,
WI,
WV,
WY
|
|
| Additional Premium for Jackson Advantage
|
Use this form to apply additional funds using your current allocation or to make allocation changes for this deposit and future deposits, if desired.
|
Payments & Deposits
|
NV6261 04/20
| NY |
|
| Additional Premium for Perspective, Perspective II, Perspective Advisory, Focus, L Series and Rewards
|
Use this form to apply additional funds using your current allocation or to make allocation changes for this deposit and future deposits, if desired.
|
Payments & Deposits
|
NV6243 04/20
| NY |
|
| Additional Premium for Perspective Advisors II
|
Use this form to apply additional funds using your current allocation or to make allocation changes for this deposit and future deposits, if desired.
|
Payments & Deposits
|
NV6245 04/20
| NY |
|
| Additional Premium for Perspective Advisory II
|
Use this form to apply additional funds using your current allocation or to make allocation changes for this deposit and future deposits, if desired.
|
Payments & Deposits
|
NV6260 04/20
| NY |
|
| Additional Premium for Perspective Advisory II and Jackson Private Wealth
|
Use this form to apply additional funds using your current allocation or to make allocation changes for this deposit and future deposits, if desired.
|
Payments & Deposits
|
V6260 04/20
| AK, AL, AR, AZ, CA…
AK,
AL,
AR,
AZ,
CA,
CO,
CT,
DC,
DE,
FL,
GA,
HI,
IA,
ID,
IL,
IN,
KS,
KY,
LA,
MA,
MD,
ME,
MI,
MN,
MO,
MS,
MT,
NC,
ND,
NE,
NH,
NJ,
NM,
NV,
OH,
OK,
OR,
PA,
RI,
SC,
SD,
TN,
TX,
UT,
VA,
VT,
WA,
WI,
WV,
WY
|
|
| Add-On Benefit Election/Termination Guaranteed Minimum Withdrawal Benefit
|
Use this form to add or terminate a GMWB.
|
Other Transactions
|
V4390 08/20
| AK, AL, AR, AZ, CA…
AK,
AL,
AR,
AZ,
CA,
CO,
CT,
DC,
DE,
FL,
GA,
HI,
IA,
ID,
IL,
IN,
KS,
KY,
LA,
MA,
MD,
ME,
MI,
MN,
MO,
MS,
MT,
NC,
ND,
NE,
NH,
NJ,
NM,
NV,
OH,
OK,
OR,
PA,
RI,
SC,
SD,
TN,
TX,
UT,
VA,
VT,
WA,
WI,
WV,
WY
|
|
| Add-On Benefit Election/Termination Lifetime Income Rider/Lifetime Income Benefit
|
Use this form to add or terminate a Lifetime Income Rider or Lifetime Income Benefit.
|
Other Transactions
|
X4390 06/20
| AK, AL, AR, AZ, CA…
AK,
AL,
AR,
AZ,
CA,
CO,
CT,
DC,
DE,
FL,
GA,
HI,
IA,
ID,
IL,
IN,
KS,
KY,
LA,
MA,
MD,
ME,
MI,
MN,
MO,
MS,
MT,
NC,
ND,
NE,
NH,
NJ,
NM,
NV,
OH,
OK,
OR,
PA,
RI,
SC,
SD,
TN,
TX,
UT,
VA,
VT,
WA,
WI,
WV,
WY
|
|